B-Vitals      is designed to be an indispensable part of pediatric diagnosis by providing early identification of behavioral health problems and offering evidenced-based recommendations for the treating provider, child, and family.


Knowing When to Step Away

It was Thanksgiving Day, and I was knee-deep in dinner preparations. Despite my intentions to plan well in advance, it felt like a race against the clock, with last-minute grocery shopping for ingredients, planning table space for 16 guests, making additional dishes to accommodate the one vegetarian in the group and coordinating with family from out-of-town.

As it turned out, I was preoccupied with more than just dinner. I remembered some unfinished tasks from
my psychotherapy practice, and the fact that I needed to take my car to the mechanic. I was wondering how I could help my 23-year-old daughter, who is looking for a new job. And, as usual, I was thinking about my son, Noah.

Four Practical Ways to

Build Self-Esteem in Students

I was reminded of the central role that self-esteem plays in the success of students during a conversation I had last year. I wasn’t hosting a focus group, yet it all but turned into one as I talked with several young people about their challenges. Each one struggled with anxiety, lack of confidence, poor study skills, and self-doubt.

You might say that’s normal for adolescents in any generation and you’d be right. After 38 years of teaching students, however, I think I see an environment today that makes the challenge especially difficult.

1. The Role of Social Media

Today’s teens draw so much of their sense of identity from social media and the various personas they use. Part of the struggle is that their responses are not congruent. One minute, they’re on top of the world, thanks to all the “likes” they got on Instagram. The next minute, they plummet due to other friends’ reactions to the same post.

Study Shows Father's Rejection Triggers Anxiety in Teens

Forming and maintaining positive, reciprocal relationships plays an integral role in the emotional development of adolescents, and this process begins at home. Not only do adolescents take their cues from parents when it comes to friendship skills, but a sense of belonging and connection within the family gives adolescents the confidence they need to achieve independence and cultivate healthy relationships outside of the family unit.

While looking to the parenting style of the mother to understand problematic adolescent behavior and/or struggles with mental health is commonplace, a new study shows that it’s essential to look at family climate as a whole. Researchers from Penn State’s Prevention Research Center looked at how parental rejection and family climate affects adolescent friendships and loneliness related to social anxiety

All Autistic Behavior is Not Communication

Every time I write about extremely aggressive or self-injurious behaviors – either those my son Jonah exhibited before he was medically stabilized in 2010, or those of other autistic teens I know who have detached their own retinas or smashed their heads against walls or floors to the point of traumatic brain injury – several commenters inevitably blame us, the parents, for just not understanding what our children are trying to communicate. For example, “BP” wrote, “You know what the key is? FIND A MEANS OF COMMUNICATION THAT WORKS FOR THEM…Just because they don’t communicate the way you do doesn’t mean they don’t understand or anything. It just means that YOU don’t understand them and are actually refusing to do so.” Echoed “Lara,” “GET IT? Any violence that happens is a direct result of an Autistic person being misunderstood and not appropriately accommodated.” And “joqatana” stated: “It’s about us trying to communicate with you and being punished for it from childhood because you refuse to learn OUR language…Your kid is trying to tell you something and YOU AREN’T LISTENING.”

The Rise of Cyber-Victimization

I suspect that very few of you are aware that Sigmund Freud wrote a book about jokes. No, not the Sigmund Freud collection of hilarious after-dinner jokes and anecdotes. It’s called The Joke and its Relation to the Unconscious and it explores the psychological purpose of joke telling, wit, comedy, and teasing [1]. He argues that jokes and witticisms are often socially acceptable ways of expressing views and emotions that otherwise would cause offense.


A joke usually involves a joke-teller, an audience or listener, and a butt or scapegoat, with the joke itself often directing hostility or cynicism towards the butt of the joke but in a socially acceptable way that involves pleasure and laughter (at least for the joke teller and the audience). The joke can represent a concealed form of aggression that bestows the joke teller with some degree of dominance and social control and the butt of the joke with stigma and rejection. 

6 Parenting Tips for Raising Kids With ADHD

When Hal Meyer learned that his son, 5, had ADHD, he couldn’t believe it. When his child was at school, “He was rambunctious, he couldn’t stay in his seat, he was going around, helping everybody,” Meyer recalls. But to him and his wife, these were signs of brightness and curiosity, not symptoms of inattention, impulsivity, and hyperactivity.


But experts told them, “You don’t understand. These are not typical of a 5-year-old.”

After they explained the disorder, the couple took a long time to accept the news. “We went through a year or two of denial,” Meyer says.

That was 20 years ago. Since then, Meyer has learned a lot about raising a child with ADHD. He shares those lessons with other parents who are dealing with the power struggles, tantrums, low self-esteem, and school problems that often come with the disorder.

Love Isn’t Enough: 
When external influences plant small seeds of fear in our children


When Sophia was only four years old, it began. Her bedtime ritual, which had previously been a pleasant hour with Mom and Dad, suddenly became stressful and exhausting. All at once Sophia began to react violently and throw tantrums to avoid being tucked into bed.

Evenings were full of screaming and yelling and frustrations. It was exhausting, not just for Sophia, but also for the rest of the family. Her loving and devoted parents tried various strategies they found in books and online, but nothing helped.

Instead, Sophia’s condition worsened as time went by. When her mother took some time off to go shopping, exercise, or meet with friends, Sophia sobbed her heart out. It all came to a head when the family received a telephone call from Sophia’s teacher saying she had hit one of the other girls in school. Not just hit her, but screamed right in her face.

Wild, Fun-loving, and Free

Brad, who has just turned three, was adopted by Fred, a medical intern, and his wife, Cher. Last year Brad spent four days a week in daycare, since Cher needed to work part time and was told Brad would benefit socially. 

     Brad’s teachers reported that when Brad didn’t get his way, he expressed his frustration and anger by hitting others, wildly trashing about, refusing to take redirection. During this last month, however, Brad was learning to use language in lieu of hitting. When his teachers threatened to report a recent incident to his parents, he immediately shot back, threatening to report them instead. 

    While continuing to engage his teachers by wildly trashing about, Brad, full of fun-loving antics, was still by far their favorite. 

Wean Your Kids and Yourself Off Fear

When my husband was 11, he biked alone, on a push-bike without gears, across Yorkshire; a one hundred mile journey on roads he had never been before and without any way of contacting his parents until he reached his destination. It is no surprise that he grew up to be independent, a mountain climber, an explorer, a scientist, a lover of the wild, and even now goes off alone into the bush or on his kayak in the knowledge that he can take care of himself, and has the skill and experience to find his way out of most unforeseen and possibly dangerous situations. The secret is that for him, the risks are worth it.

When I was a child I was rarely driven anywhere; if I wanted to go somewhere I found a way to get there. Home was somewhere you left at eighteen and returned to at holiday time. So it is no surprise that our four children all left home when they went to university or got their first job, travelled alone or with friends to the other side of the world for two or more years as young adults, supporting themselves by working in all manner of jobs and in many countries, and are consequently self-reliant and at ease with their ability to look after themselves in situations many would find scary and daunting. Except, that is, in their more recent concerns for their own children as they become teens in this world we now live in.

The New Standard of Pediatric Behavioral Health Assessment

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